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<title>JAMA -- Abstract: Direct Detection of Bacterial Biofilms on the Middle-Ear Mucosa of Children With Chronic Otitis Media, July 12, 2006, Hall-Stoodley et al. 296 (2): 202</title>





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<meta name="citation_title" content="Direct Detection of Bacterial Biofilms on the Middle-Ear Mucosa of Children With Chronic Otitis Media">
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		Vol. 296 No. 2, July 12, 2006</font></th>
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		Preliminary Communication </font></th>
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		<font color="#003366" size="4" face="verdana, arial, helvetica, sans-serif"><strong>

Direct Detection of Bacterial Biofilms on the Middle-Ear Mucosa of Children With Chronic Otitis Media
</strong></font><p>


<font size="2" face="verdana, arial, helvetica, sans-serif">
<nobr>Luanne Hall-Stoodley, PhD</nobr>; 
<nobr>Fen Ze Hu, PhD</nobr>; 
<nobr>Armin Gieseke, PhD</nobr>; 
<nobr>Laura Nistico, PhD</nobr>; 
<nobr>Duc Nguyen, PhD</nobr>; 
<nobr>Jay Hayes, BS</nobr>; 
<nobr>Michael Forbes, MD</nobr>; 
<nobr>David P. Greenberg, MD</nobr>; 
<nobr>Bethany Dice, BS</nobr>; 
<nobr>Amy Burrows, BS</nobr>; 
<nobr>P. Ashley Wackym, MD</nobr>; 
<nobr>Paul Stoodley, PhD</nobr>; 
<nobr>J. Christopher Post, MD, PhD</nobr>; 
<nobr>Garth D. Ehrlich, PhD</nobr>; 
<nobr>Joseph E. Kerschner, MD</nobr>
</font><br>

</p><p><font size="2" face="verdana, arial, helvetica, sans-serif">
<em>JAMA.</em>&nbsp;2006;296:202-211. 
</font></p><p>

<!-- ABS -->
<!--startindex--><font size="2" face="verdana, arial, helvetica, sans-serif">
<b>Context&nbsp;</b> Chronic otitis media (OM) is a common pediatric<sup> </sup>infectious disease. Previous studies demonstrating that metabolically<sup> </sup>active bacteria exist in culture-negative pediatric middle-ear<sup> </sup>effusions and that experimental infection with <i>Haemophilus influenzae</i><sup> </sup>in the chinchilla model of otitis media results in the formation<sup> </sup>of adherent mucosal biofilms suggest that chronic OM may result<sup> </sup>from a mucosal biofilm infection.<sup> </sup></font></p><p>

<font size="2" face="verdana, arial, helvetica, sans-serif"><b>Objective&nbsp;</b> To test the hypothesis that chronic OM in humans<sup> </sup>is biofilm-related.<sup> </sup></font></p><p>

<font size="2" face="verdana, arial, helvetica, sans-serif"><b>Design, Setting, and Patients&nbsp;</b> Middle-ear mucosa (MEM)<sup> </sup>biopsy specimens were obtained from 26 children (mean age, 2.5<sup> </sup>[range, 0.5-14] years) undergoing tympanostomy tube placement<sup> </sup>for treatment of otitis media with effusion (OME) and recurrent<sup> </sup>OM and were analyzed using microbiological culture, polymerase<sup> </sup>chain reaction (PCR)-based diagnostics, direct microscopic examination,<sup> </sup>fluorescence in situ hybridization, and immunostaining. Uninfected<sup> </sup>(control) MEM specimens were obtained from 3 children and 5<sup> </sup>adults undergoing cochlear implantation. Patients were enrolled<sup> </sup>between February 2004 and April 2005 from a single US tertiary<sup> </sup>referral otolaryngology practice.<sup> </sup></font></p><p>

<font size="2" face="verdana, arial, helvetica, sans-serif"><b>Main Outcome Measures&nbsp;</b> Confocal laser scanning microscopic<sup> </sup>(CLSM) images were obtained from MEM biopsy specimens and were<sup> </sup>evaluated for biofilm morphology using generic stains and species-specific<sup> </sup>probes for <i>H influenzae, Streptococcus pneumoniae,</i> and <i>Moraxella<sup> </sup>catarrhalis</i>. Effusions, when present, were evaluated by PCR<sup> </sup>and culture for evidence of pathogen-specific nucleic acid sequences<sup> </sup>and bacterial growth, respectively.<sup> </sup></font></p><p>

<font size="2" face="verdana, arial, helvetica, sans-serif"><b>Results&nbsp;</b> Of the 26 children undergoing tympanostomy tube<sup> </sup>placement, 13 (50%) had OME, 20 (77%) had recurrent OM, and<sup> </sup>7 (27%) had both diagnoses; 27 of 52 (52%) of the ears had effusions,<sup> </sup>24 of 24 effusions were PCR-positive for at least 1 OM pathogen,<sup> </sup>and 6 (22%) of 27 effusions were culture-positive for any pathogen.<sup> </sup>Mucosal biofilms were visualized by CLSM on 46 (92%) of 50 MEM<sup> </sup>specimens from children with OME and recurrent OM using generic<sup> </sup>and pathogen-specific probes. Biofilms were not observed on<sup> </sup>8 control MEM specimens obtained from the patients undergoing<sup> </sup>cochlear implantation.<sup> </sup></font></p><p>

<font size="2" face="verdana, arial, helvetica, sans-serif"><b>Conclusion&nbsp;</b> Direct detection of biofilms on MEM biopsy<sup> </sup>specimens from children with OME and recurrent OM supports the<sup> </sup>hypothesis that these chronic middle-ear disorders are biofilm-related.<sup> </sup></font></p><p>

<font size="2" face="verdana, arial, helvetica, sans-serif"></font><br clear="right">

<font size="2" face="verdana, arial, helvetica, sans-serif">
<b>Author Affiliations:</b> Center for Genomic Sciences, Allegheny-Singer Research Institute, Pittsburgh, Pa (Drs Hall-Stoodley, Hu, Gieseke, Nistico, Nguyen, Forbes, Stoodley, Post, and Ehrlich and Mr Hayes and Ms Dice); Department of Microbiology and Immunology, Drexel University College of Medicine, Allegheny Campus, Pittsburgh (Drs Hall-Stoodley, Hu, Stoodley, Post, and Ehrlich); Department of Molecular Ecology, Max Planck Institute for Marine Microbiology, Bremen, Germany (Dr Gieseke); Children's Hospital of Pittsburgh, Pittsburgh (Dr Greenberg); and Children's Hospital of Wisconsin, Medical College of Wisconsin, Department of Otolaryngology, Milwaukee (Ms Burrows and Drs Wackym and Kerschner).
</font></p><p>


		
	
	
	
	
	
    
	
	
	
	
        
        
	
	
	
	
	


		 

		
		
		
		
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